"diarrhea is defined as having stools that occur more than three times a day and a looser than usual specifically 200 grams 24 hours is considered diagnostic but as you can imagine trying to measure the weight of stools in everyone referring to diarrhea would be a mess literally so first off the call divide them into acute and chronic causes for start acute diarrhea is defined as lasting less than four weeks and is often caused by infections that they usually eat a viral or toxin-mediated typically they will resolve spontaneously I see cases lasting more than four weeks need to be divided into either organic or functional causes and the difference between them is that organic causes can be detected or Quantified through testing while functional causes cannot samples of organic causes include celiacs disease inflammatory bowel disease like ulcerative colitis or Crohn's disease we can also have bacterial and parasitic infections pain and of course intestinal neoplasms on the other hand functional causes of chronic diarrhea include irritable bowel syndrome lactose intolerance food alcohol how then can we begin to narrow down the causes when we encounter a patient with diarrhea let's first tackle how to distinguish functional from organic diarrhea firstly the duration of secondly the volume of organic diarrhea is usually larger than in functional next we look for the presence or absence of blood functional will never have blood while organic often does we can also ask about the naming organic doesn't have any specific pattern but may wake the patient up at night well functional is usually in the morning and will not wake the patient up this is also closely tied to stress where organic diarrhea doesn't have much Association to stress but functional diarrhea often coincides with we take this few seconds our valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic classic functional medicine Back to Basics health tips and special updates from the best doctors in the United States of America check out this health and wellness podcast shows explore Health talk weekly healthy lifestyle matters excellent Health digest healthy and free daily and last but not least weekly Health and Fitness also check out nasty boy CC the truest story never told Fiction podcast for that real-life on-the-go experience with the 27 year old Golden Boy Who made our guest he tells us about his story as it happens in real time and in real life it's nasty boy CC the truest story never told go get a load of that happiness because happiness is healthy as we know it join us every week as we continue to provide you the best of health and fitness Wellness updates from around the globe enjoy the show"

"...chronic kidney disease or chronic renal failure is a progressive irreversible condition characterized by either a reduction in kidney function or kidney damage as a result of any cause that a present for more than 3 months it is divided into stages based on the glomerular filtration rate which is a measure of how well the kidneys are functioning it shows the flow rate of filtrate through the glomerulus of the Nephron into the Bowman's capsule and ultimately through the renal tubules the stages are labeled 1 to 5 with 2 groups in stage 3 the definition of a reduced GFR is below 60 milliliters per minute but in groups 1 and 2 the GFR may actually be above 60 but there is evidence of kidney damage end-stage renal disease is classed as a GF are below 15 or the need for renal replacement therapy like dialysis or renal transplant kidney damage can be defined as signs of damage seen on Imaging or on testing such as a high albumin to creatinine ratio which is a measurement of the amount of protein lost in the urine in fact in combination with GFR these patients are divided into three food groups based on the albumin creatinine ratio with higher values indicating more damage and an increased likelihood of progression initially chronic kidney disease may not cause many problems and it is often asymptomatic however as it progresses it brings with it several significant complications these can include an elevated cardiovascular risk with patients are 5 to 10 times more likely to die from cardiovascular disease than end-stage renal disease the risk of stroke has been found to increase as the GFR lowers around seven percent for every 10 ml per minute lost this may also be the result of CKD contributing to hypertension as well as being caused by it this can be due to activation of the renin-angiotensin-aldosterone system and can also be because as the disease progresses the kidney is less able to excrete leading to retention and subsequent fluid overload signs of fluid overload could be dismissed near due to pulmonary edema or a fusion and peripheral edema or ascites anemia is also common which contributes to disappear and can come from a reduction in erythropoietin from the..."

a sudden deterioration in the function of the kidneys is known as an acute kidney injury sometimes also called acute renal failure to measure this reduction in kidney function glomerular filtration rate or GFR is normally used which is a measurement of how well the kidneys are filtering the blood the functional unit of the kidney that actually does this is the Nephron made up of the glomerulus which is a modified capillary and as blood passes through it the waste is filtered into the Bowman's capsule GFR is the volume filtered through the glomerulus into the Bowman's capsule and through the Nephron in a given unit of time the filtrate passes along through the proximal convoluted tubule Loop of henle distal convoluted tubule and the distal collecting duct undergoing secretion and reabsorptionas it travels ultimately it forms urine and collects into the renal pelvis and passes into the bladder through the ureter to directly measure this process is difficult we instead use creatinine clearance to estimate the GFR creatinine is a normal breakdown product of creatine released from muscle tissue and this is freely filtered by the glomerulus and is not reabsorbed so fits the kind of substance we need however creatinine is secreted into the filtrate by the peritubular capillaries so it does tend to overestimate the GFR slightly the cockcroft and Gault formula is a famous formula used to estimate the creatinine clearance and therefore GF are taking into account age Mass gender and the serum creatinine as it travels ultimately it forms urine and collects into the renal pelvis and passes into the bladder through the ureter to directly measure this process is difficult we instead use creatinine clearance to estimate the GFR creatinine is a normal breakdown product of creatine released from muscle tissue and this is freely filtered by the glomerulus and is not reabsorbed so fits the kind of substance we need however creatinine is secreted into the filtrate by the peritubular capillaries so it does tend to overestimate the GFR slightly the cockcroft and Gault formula is a famous formula used to estimate the creatinine clearance and therefore GF are taking into account age Mass gender and the serum creatinine

polycystic kidney disease is a condition characterized by the development of multiple cysts within the renal tubules of the kidney and is the most common hereditary renal disease the normal functional unit of the kidney is the nephron made up of a glomerulus and Bowman's capsule proximal convoluted tubule Loop of henle distal convoluted tubule and the collecting duct blood filters through the glomerulus forming filtrate which then passes through the tubules undergoing see and reabsorption eventually forming urine and passing into the ureter and bladder overall there are around 1 million of these nephrons in each kid in polycystic kidney disease these tubules develop into cysts which become filled with fluid and can range in size from being microscopic to several centimeters in size the process can start even in utero meaning in the womb as the tubules become cysts they cannot carry the normal filtering function therefore the number of functioning nephrons begins to decrease this is worsened by the fact that as the cysts grow they compress nearby nephrons also making them dysfunctional initially this may not be seen to have any clinical impact as the remaining number of nephrons may increase there to maintain the glomerular filtration rate but as the disease progresses and more nephrons are affected the remaining ones cannot make up the difference overall renal function then deteriorates eventually reaching end-stage renal disease by definition the presence of structural injury makes polycystic kidney disease a form of chronic kidney disease with end-stage renal disease being defined as needing renal replacement therapy like dialysis or transplant or a GF far below 15 ml per minute there are two main types of polycystic kidney disease both caused by genetics the first is autosomal dominant with two main types one coming from mutations in P KD 1 on a chromosome 16 which codes for the protein polycystic in this is affected in around 85% of cases and is involved in cell to cell or cell Matrix interaction cell cycle regulation and calcium transport the second coming from mutations in PKD to on chromosome for coding for Polly system to which codes for

Nephrotic syndrome is a collection of signs and symptoms that result from damage to the kidneys and is often confused with nephritic syndrome in fatigue syndrome there is a substantial amount of protein being lost through the kidneys in the urine defined as more than 3.5 grams per day this leads to hypoalbuminemia a low level of albumin in the blood as albumin is the most abundant protein normally in the blood these two are defining features in nephrotic syndrome nephritic syndrome is different in that there is less proteinuria but also the presence of hematuria and red blood cell or white blood cell casts in the urine hypertension and oliguria which is a reduced urine output typically between 80 and 400 ml per day the unit of the kidney is the nephron and normally in the glomerulus of the Nephron there is a specialized membrane that forms the filter made up of a fenestrated endothelium the Maryland basement membrane and the foot processes of podocytes which are cells that wrap around the capillary giving this additional filtration layer all together these structures normally act as a filter and prevent large molecules from passing through into the Bowman's capsule and renal tubules they have a net negative charge which may mean that they can repel other negatively charged molecules albumin is negatively charged in the fatigue syndrome there is sufficient injury to these structures to change the permeability and allow albumin and other molecules to pass into the urine leading to hypoalbuminemia the signs and symptoms linked to hypoalbuminemia which includes peripheral edema and fluid overload particularly in children this can be evident as facial swelling but can also occur in adults particularly around the eyes fluid overload can mean weight gain peripheral edema and even the development of ascites or pleural effusion which can manifest as shortness of breath known as this near the reduction in the blood levels of albumin causes the oncotic pressure of the blood 24 meaning fluid will more readily leak into the surrounding tissues causing edema this is sensed as hypovolemia because less fluid is in the vessels which then triggers the renin-angiotensin-aldosterone system causing retention of salt and water this is known as the underfill hypothesis while another is the

.nephritic syndrome is a collection of signs and symptoms that result from glomerulonephritis which is inflammation of the kidney specifically the glomerulus this could be remembered because it means inflammation rather than being a disease itself nephritic syndrome is the manifestation of an underlying disease that causes the inflammation and there are many of these causes it is easily confused with nephrotic syndrome which instead is a collection of signs and symptoms resulting from a high amount of protein being lost through the kidneys in the urine this leads to hypoalbuminemia meaning low levels of albumin in the blood these are the two defining features in nephrotic syndrome there is some overlap but nephritic syndrome is different in that the degree of proteinuria is lower and there is the dozens of hematuria meaning blood in the urine which could be microscopic or macroscopic red blood cell casts in the urine sterile / urea which is the presence of white blood cells without evidence of bacteria hypertension and oliguria which is a reduced urine output typically between 80 and 400 ml per day the functional unit of the kidney is the Nephron which includes the glomerulus and modified capillary surrounding

"...tennis elbow and golfer's elbow a to similar conditions causing pain in the elbow and a medically know is lateral and medial epicondylitis respectively this means inflammation of the epicondyles which are bony protuberance has on the distal of the humerus the elbow is made up of the humerus articulated with the radius and ulna and allows for flexion and extension of the forearm however there are muscles that attach to the epicondyles that allow for wrist hand and finger movements like grasping and twisting and repetitive use of these muscles is thought to lead to micro attendance generating pain for this reason the conditions are known as enter Sapa these-- which means attachment point disease in act more recently it has been recommended that the conditions be referred to as tendinosis or epicondyle Alger rather than epicondylitis as histologically there is usually granulation tissue and a lack of traditional inflammatory cells suggesting that degeneration of the tendon maybe more an inflammation in the pathogenesis Motions like using handheld tools or even drawing are associated with the conditions and the names are slight misnomers is playing tennis can give you golfer's elbow and vice versa over all the movements causing the conditions do not necessarily need to be sports-related in some cases they can be triggered by a sudden contraction possibly from trauma elbow pain is the primary symptom in each lateral like this is 7 to 10 times more common and the pain is on the lateral or outer part of the elbow usually on the dominant hand it is generally worsened by extension of the wrist or fingers as the muscles responsible for these movements attached to the lateral epicondyle collectively known as the extensor tendons in particular the extensor carpi radialis brevis is commonly affected in lateral epicondylitis there is typically worsening of the pain with wrist extension against resistance when the is extended known as cozens test medial epicondylitis is less common but features pain on the medial or inner of the elbow it comes from tendinosis of the flexor and pronate attendance which originate from the medial epicondyle in particular the carpi radialis and the pronator teres and most commonly affected the pain is usually reproduced when the wrist is flexed and pronated against resistance well the is flexed called the reverse cozens test overall it is usually a gradual onset of pain that progressively get worse and can persist at night it also tends to be worsened by use of the forearm such as grasping and the pain may also be elicited by palpating several millimeters distal to the air condyles which corresponds with the location of the tendons people may also experience weaker grip strength the diagnosis is largely meaning no specific test or Imaging is required to make a diagnosis however Imaging like x-ray may be done to rule out arthritis of the elbow..."

...arm in an anterior dislocation due to the posterolateral portion of the humeral head being compressed against the anterior part of the glenoid labrum they can be compression fractures on the humerus known as Hill Sachs lesions they are closely linked with bankart lesions which is a rupture in the glenoid labrum these can also be accompanied by avulsion fractures which are then termed bony bankart lesions the arm is typically held in external rotation with some abduction and all movements are painful there is a loss of the normal Contour of the deltoid and the acromion can be particularly prominent posterior dislocation 's make up only two to four percent of all shoulder dislocations and occur due to the head of the humerus being forced posteriorly while...

that fits that hole in this case the space formed by the tibia and fibula and the projection which is the Dome of the talus bone ligaments helped provide more stabilization there is the medial or deltoid ligament coming from the medial malleolus which branches into four ligaments and is mostly involved in preventing / e-version while the lateral ligament comes from the lateral malleolus and is made up of three ligaments with the main function of preventing over inversion of the foot in 70% of cases there is an isolated fracture of either the medial or lateral malleolus if both the fractured this is termed a bye the fracture seen in twenty percent of cases and if the posterior malleolus is also fractured this is called a try malleolus fracture but this is only the case in fewer than

"...Osgood-Schlatters disease also known as tibial tubercle apophysitis is a condition characterized by the anterior knee due to inflammation of the apophysis and apophysis is a normal developmental protuberance from a bone that provides an insertion site for tendons in this case the patellar tendon on to the tibial tubercle it primarily affects children and adolescents because by adulthood the apophysis will fuse with the rest of the tibia it is weaker than 10 and so is prone to injury Osgood-Schlatters disease is a stress or traction injury that occurs due to repetitive Force being applied through the strong patellar tendon on to the tibial tubercle typically from movements involving leg extension such as running or jumping but also during growth spurts the force can lead to small avulsion fractures of the tibial tubercle apophysis generating and pain and in rare cases a complete avulsion of the tibial tubercle knee pain is the most common symptom which is on the anterior portion of the knee just below the patella in most cases it is unilateral but both sides are affected in around 30 percent of cases in general it has an Insidious gradual onset with no trauma and may initially be episodic but go on to become continuous the tibial tubercle itself can be tender to touch and may have some Associated enlargement which can be felt as a prominent lump males in particular are up to seven times more likely to be affected..."

"...for those of you who have not tuned in to us we run essentially a chronic pain practice board Gates is board certified functional neurologist I'm a board-certified functional medicine practitioner we melded those two disciplines into a model of care to address a substantial portion of chronic conditions chronic Jesus and and although we cure few we're able to help most get under some some control quite considerable control and be able to manage their case and the properly selected and the properly cite the patient the reason we cure for you is because pretty much everybody walks in here ends up having an autoimmune problem and they also usually walk in here under a chronic stress with a chronic stress response usually we caught a sympathetic dominance or fight-flight system is engaged and it doesn't tend to let go these things can lead to anxiety Sia T panic attacks depression things of that nature and I lead off with that to say one of my one of my one of my points with people when they come in and I address this with them is my observation based on watching what happens with the brain rehab exercises that we do in certain other types of supplementation is that these are not necessarily personality disorders their poor frontal lobe this sort of and there's a lot of things that add to causing your frontal lobe to not work properly poor poor lack of blood supply to your Bruno lobe from anemias be your frontal lobe needs oxygen inflammation which are probably going to talk about a little bit blood sugar stress hormones and and so but lately we've been seeing last couple of years maybe we've been even seeing little kids come in we're stressed out of their minds and like two or three years old and say what's going on with that and then other people who've had just this kind of stress responses that seemed to be like even a little bit over a top for what we see and and dr. Gates is going to share with you some of the things that he's come across in that in the literature that we've been implementing and what are our Protocols are and kind of giving you the understanding that I know stress hormones now can cross the placenta from the stressed mother into the young person but there's even more to it than that our genetic components that need to be considered if they're there and that oftentimes respond well to the types of things that can be done wow without drugs frankly so yeah we treat a lot of patients with fibromyalgia in our clinic at least we have and that's actually started off with yeah that's kind of how we got into depression because a lot of patients were coming in with their fibromyalgia and they didn't want to take medications for the depression so they said well can you handle what could you do so that started us on this quest in this journey of..."

"...so we're going to talk about Hashimoto and Plastics today Hashimoto's is a subject that we've been long associated with frankly probably for most people are associated with and we're taking quite a bit of use for even diagnosing people at and so and getting heat on it and the point from that is that Hashimoto is the understanding of what's going on with Hashimoto's is the number of things it's related to the things that can create a Hashimoto's isn't it is an immune attack on your thyroid primarily and so you're always looking for the things that are creating the immune attack and and and it can be a multitude of things and I was just mentioning to dr. Gates we're talking about Plastics that I remember reading about that at like 10 years ago but wondering is actually something that has something to do with it because back then it was I was everything was Metals was right it was it was is there anything you could think of the alternative groups were putting out as yet avoid all of this which is basically everything in life it seemed like but it turns out that Plastics do create a negative effect on the condition of Hashimoto's and so we're going to discuss that this probably fairly briefly it's not a long topic I would assume and so and if it's not brief then that's fine too so so Plastics as the famous gentleman in the Dustin Hoffman movie from many years ago The Graduate said to Dustin Hoffman when he had him in his graduate courses okay so I'm 65 days going to be people more my age The Graduate it was the famous line for the decade when people would say what are you going to do with your life and people Go Plastics because the gentleman at his college graduation party pulled him over and he was wondering what he was going to do for a because back in 1965 r68 Plastics were just coming into that was the whole point of plastics were done where Evolution just coming in and nobody knew anything about them they were going to save the world now we've got some mass of plastics I guess twice the size of Texas under the Pacific Ocean from what I read in the the other day and the National Geographic so could be a problem that was the whole point of that that aside that I was warned not to do yesterday but I did so good so the whole question is why is Hashimoto's so much more common and..."

"I never heard a group okay and so the bottom line is that he was talking about that a long time ago it's been around a while when I started to see the Improvement in my page consistently I thought wow this is what I want to do for a living and I had no clue 0 no clue at all that I was going to become conversant in gut problems I did that was going to become in thyroid problems there's going to have to become conversant and hormonal issues but the biggest thing is I had no clue art practice with developed into a man it's almost virtually 100% so this immune issue the autoimmune issue and the Celiac and the non-celiac gluten sensitivity all really go together I know mites I hope we haven't thrown out too much I hope we have a like confused you on this matter if we have confused on this matter because it's a complex matter and if just get that to you then relative to these chronic problems than that's good but we go back to the beginning of this and the bottom line is is there is such a thing as non-celiac gluten sensitivity we see it everyday it is hugely important for you to understand that if you are eating eating glue is creating incentives and you amount of what the tests say you get off of it and you need to stay off of it the tests are convoluted I am certain that what we are telling you is going to be proven not only is it's been proven in the but in future testing the testing I think is in evolution I think they will be better like the test that you just got talking about the dma believe Mom feels that is a better test is pretty cost-effective it's not real expensive so I think we're going to see this thing calm down as time goes on I don't think the gluten free market is going to go away that'll that'll sink"

...yeah I'm giving a presentation every week on different topics that we treat and we share with you research we share with you our results occasionally our failures and whatever we can do to help you get a better grip on your situation and sometimes even things that will help you this is our first of the month answering questions session and the questions this month we went over them last night are pretty good they show a lot of thought so we're going to start into these I'm just going to read the questions and then we'll answer them as it hits us as to who should answer them or so the first one what can we do to calm our fight or flight in our brains I grew up with horrific childhood abuse as well as a multitude...dude abusive relationships so yes my brain has a broken brake pedal so somebody's been listening that's what that's for sure I have done meditation sound therapies and doing things that truly excite me like anything pertaining to water I assume that's like water sports and swimming I have to enjoy I also enjoy ASMR I'm not sure if maybe it maybe EMDR that's kind of what I was thinking but I wasn't sure okay maybe okay we have ASMR neither one of us know what that is EMDR might make sense mgrs the type of relaxation technique that is used and do you have any suggestions I'm going to go right to you at that we had this conversation briefly the other day when we talked about the stress responses key you know you do get the stress response on the control it's hard to get anybody...

"...So today we're going to talk about Alzheimer's and sleep and more or less the basic concept of what we're going to talk about is Alzheimer's cause sleep problems or do sleep problems cause Alzheimer's kind of we're going to have kind of a chicken or the egg type of a discussion here today and we just saying that dr. Gates depending on someone asked this yesterday and asked me to retrieve a lot of Alzheimer's and according to that one classification system that has like seven stages so probably 90% of our patients be classified as having some stage of Alzheimer's we treat a lot of stress and stress hormones tend to hit something called your hippocampus and you're going to find out a little bit about the hippocampus that I and stress hits that hippocampus and the hippocampus...cause of sleep problems and so there are so there are the cycles that hit the hippocampus of different things and the hippocampus is where your short-term memory is and it's where I think it's pretty upon the Alzheimer's begins so so we see a lot of people with early I forget walking in the rooms I I can't I can't find my so remember where I put my lost my train of thought and I'm starting to get short-term memory loss my working marriage something like that which may not be called full-blown Alzheimers at that point I would buy that classification system here on so we see a lot of people with this and it doesn't mean that you're going to go there either and so when we say Norris every patient they we're not saying 90% have Alzheimers caressing doctor suffer the same fate as far as the classification act so you have to look at it it's like if you have is act exactly as you said if you walk into a room you don't know you're there you're like stage one yeah..."

...so Alzheimer's is kind of an interesting topic I still keep hearing nobody's found the cause of it yet I'm not sure there is a the cause relative to that and and and then our observation we do a lot of chronic pain that's what we do for those of you haven't seen us we combine functional medicine and functional neurology to create a paradigm to address kind of the cornerstones of physiology that seemed to be the core of what causes chronic conditions chronic pain in general and so if a person comes in here let's say with fibromyalgia it's pretty common that they're going to have brain fog and short term memory loss and and people come in here and there in PTSD there they're going to have short-term memory loss they're going to have they're going to have difficulty sleeping and things of that natur...going to bed but a substantial portion of our patients come in here with short-term memory loss and brain fog and and other things that you know have that Nuance of is this house hi so the Alzheimer's type of thing we have seen Alzheimer's patients but more often we see people who would seem to me to be in the process of going in that direction so it's of Interest to us to know what's going on and and so this is something that isn't that is it's enveloped in that core of conditions and and of problems chemical problems chemical Pathways neuronal pathways systemic problems that cause chronic problems chronic pain fibromyalgia preferably chronic fatigue dizziness vertigo balance a lot of these things it's interesting how they kind of overlap...

"...on polycystic ovarian syndrome PCOS and depression today much to my surprise doctor uh Justin for me we've never done one which is because we've done a lot of talk on PCOS and we see it a lot pretty common clinical picture that comes in here we see a lot of thyroids to correlate coordinate with a lot of Hashimoto's types problems so I'm not exactly sure where dr. Gates is going with this because we just talked about it but this is a subject that I happen to know that we're extremely conversant with and so I'll be anxious to hear if he comes up with anything new today it's good I'm not aware of and if not I may or may not chime in what's that so PCOS and depression well what's menopause but that's what people come in...of times guys am I going into menopause yeah yeah and actually some of the lead Endocrinology researchers will say that most women and menopause are actually kind of in a state of PCOS because at that point chemically yeah chemically so for those of you have PCOS you know how what a burden this condition really can be especially emotionally and not only affects you know your menstrual cycles and whether they're happening every month or every six months but also hair growth can be a big big factor for PCOS patients unwanted hair growth as well as those cysts on your ovaries for all intensive purposes explode at times and that can be exquisitely painful as well but PCOS is incredibly common it's one out of five females and Essence when diagnosed via the Rotterdam criteria the Rotterdam criteria was established to say that if you have two out of the three that I just mentioned if you have..."

"...and today we're going to talk about a concept that has time so I think been controversial I think at times been considered theoretical when I first got into functional medicine years ago is actually a prominent Conrad of the immune system and because what we started to realize was in chronic pain we have a chronic pain practice for those of you who haven't watched us before and we treat just about anything that won't go away and we've combined two disciplines functional neurology and functional medicine to address fibromyalgia and periphery often chronic fatigue and chronic got problems chronic thyroid problems and dizziness vertigo balance things that won't go away people get things they go away B they don't go away you need to know why and the immune system was an obvious first place to start I think for those in the field at that time that there must be something with the immune that's causing the problem there's a concept called th1 th2 shifts th1 th2 balance I've drawn the little seesaw picture of it and I think a thousand times and try and explain to people and and and I think it's I don't I think dr. Gates is going to explain to me today whether it's getting more credibility or just something that you're using more because you see it's a valuable tool because it is affecting people frequently will talk about that Gates does all the treatment now and he's always researching and frequently will tell talk to me about how this was a that this was a shift during pregnancy this is the mystical why do I get pregnant and then I feel good and then all sudden I don't after I deliver the child it's this is the if you have allergies you have a shift more towards one side than the other so and certain autoimmune problems have a certain quality..."

"...obstructive sleep apnea is a breathing disorder characterized by recurrent episodes of Airway obstruction during sleep leading to periods with breathing stops known as apnea moving from wakefulness to sleep causes relaxation of muscle tone including the muscles of the upper Airway this allows the soft palate and the tongue to relax and to create an obstruction that reduces the patency of the respiratory tract rapid eye movement or REM sleep, in particular, is known to feature this reduction in muscle tone but it can happen throughout the Sleep Cycle there is snoring when some still enter but as the obstruction progresses the airflow can be severely reduced causing apnea the reduction in the ventilation of the lungs causes a reduction in blood oxygen levels and as a result there is an interruption in sleep known as neurological arousal with a partially awakens in order to restore muscle tone and therefore oxygenation but this isn't necessarily perceived by the person partial collapses with reduced oxygen or arousals a termed hypo apneas while apnea is defined as over a 90% airflow obstruction lasting 10 longer a cycle is there for generated alternating between periods of deeper sleep and higher wakefulness with a typical sleep cycle is which ultimately disrupts the quality of sleep and can cause sleep deprivation risk factors are thought to be obesity as it increases the amount of soft tissue around the airway..."

"...I am a certified functional medicine practitioner dr. Gates, I am a board-certified chiropractic neurologist and say that from now on because I always mess it up and together we have chronic pain I say it every week kind of just evolve kind of developed on its own frankly in the efforts are actually in the efforts of me to get better from my issues but ultimately with the help of some very very talented people and we've been doing it for a while and we it's pretty much all we do now so we share we're sharing with you what we know because a lot of most people everybody comes in here with these ideas from the Internet or from their research no offense to those of you who do your research but research on the Internet is fraught with landmines I would put I think that would be an understatement but because doctors would agree with that almost got it was in today's day and age going with that yeah so so so anyway so we're going to talk about "berberine" what we want to do is put it in a context because it can be a pretty amazing adjunct to what we do some really good success with them but lately I have been seeing pamphlets going out to the nation on various things one of them was on gluten one was a for those of you have Celiac for those of you who are Gluten Sensitive it was a pamphlet to said take this supplement you can eat pizza for the rest of your life I'm trying to assimilate my disastrous that must have been for a lot of people but they probably sold a lot of their product but one right now I'm seeing a lot of is burglary products that have significant success in clinical populations are frequently taken to Market by some unfortunately some..."

"...I am a certified functional medicine practitioner dr. Gates, I am a board-certified chiropractic neurologist and say that from now on because I always mess it up and together we have chronic pain I say it every week kind of just evolve kind of developed on its own frankly in the efforts are actually in the efforts of me to get better from my issues but ultimately with the help of some very very talented people and we've been doing it for a while and we it's pretty much all we do now so we share we're sharing with you what we know because a lot of most people everybody comes in here with these ideas from the Internet or from their research no offense to those of you who do your research but research on the Internet is fraught with landmines I would put I think that would be an understatement but because doctors would agree with that almost got it was in today's day and age going with that yeah so so so anyway so we're going to talk about "berberine" what we want to do is put it in a context because it can be a pretty amazing adjunct to what we do some really good success with them but lately I have been seeing pamphlets going out to the nation on various things one of them was on gluten one was a for those of you have Celiac for those of you who are Gluten Sensitive it was a pamphlet to said take this supplement you can eat pizza for the rest of your life I'm trying to assimilate my disastrous that must have been for a lot of people but they probably sold a lot of their product but one right now I'm seeing a lot of is burglary products that have significant success in clinical populations are frequently taken to Market by some unfortunately some..."

"...a chiropractic physician and a board-certified functional neurologist this is Dr. Randul okay you know he's the fourth certified functional neurology we're certified Chiropractic neurologist technical way to had I ever immigrants your certified functional medicine practice can you tell I was just talking about 23 different things before we just started I was just told I don't think that disgusting fish oil the truth about fish oil this is dr. Gates this topic today he chose and why are we picking on fish oil because we're kind of sort of going to pick on fish oil not really like badly if you're taking fish oil doesn't mean I've stopped taking it but we spent a lot of time developing protocols to help people within with chronic pain issues chronic syndromes...we're going to be like emptying the oceans for fish oil and we're not going to make the point that it's not because obviously it has been proven to be useful for a variety of functions of the brain function and anti-inflammatory Sarah however in our clinical World we're responsible results and we have to use certain methods to change symptomatology to get conditions to calm down and or disappear and we haven't had maybe the greatest experience with fish oils ...."

"...a chiropractic physician and a board-certified functional neurologist this is Dr. Randul okay you know he's the fourth certified functional neurology we're certified Chiropractic neurologist technical way to had I ever immigrants your certified functional medicine practice can you tell I was just talking about 23 different things before we just started I was just told I don't think that disgusting fish oil the truth about fish oil this is dr. Gates this topic today he chose and why are we picking on fish oil because we're kind of sort of going to pick on fish oil not really like badly..."

"...on polycystic ovarian syndrome PCOS and depression today much to my surprise doctor uh Justin for me we've never done one which is because we've done a lot of talk on PCOS and we see it a lot pretty common clinical picture that comes in here we see a lot of thyroid to correlate coordinate with a lot of Hashimoto's types problems so I'm not exactly sure where dr. Gates is going with this because we just talked about it but this is a subject that I happen to know that we're extremely conversant with and so I'll be anxious to hear if he comes up with anything new today it's good I'm not aware of and if not I may or may not chime in what's that so PCOS and depression well what's menopause but that's what people come in...of times guys am I going into menopause yeah yeah and actually some of the lead Endocrinology researchers will say that most women and menopause are actually kind of in a state of PCOS because at that point chemically yeah chemically so for those of you have PCOS you know how what a burden this condition really can be especially emotionally and not only affects you know your menstrual cycles and whether they're happening every month or every six months but also hair growth can be a big big factor for PCOS patients unwanted hair growth as well as those cysts on your ovaries for all intensive purposes explode at times and that can be exquisitely painful as well but PCOS is incredibly common it's one out of five females and Essence when diagnosed via the Rotterdam criteria the Rotterdam criteria was established to say that if you have two out of the three that I just mentioned if you have..."

"...more with one of them and that and in and I think as we were going along we realized our patients were stressed but we would actually when we first got together we would actually say okay on this patient it's there really stress so we should do like just the brain and not do the functional chemistry and and not worry about the gut and and these people will just do the gut and not worry about it because they don't seem to be quiet and one of our big breakthroughs was to realize that most of our people were not just stressed that they were actually kind of a chronic fight flight or post-traumatic stress syndrome and it's amazing when I bring this to people in the consult it's amazing how many people acknowledged and literally stopped me in the middle of my explanation go that's me and and they had at that hadn't really given a thought to the fact that they weren't a chronic stress response and these people are of course are here because they're trying to figure out what's causing their their chronic pain..."